title: Plasma tumor necrosis factor in patients with septic shock. Mortality rate, incidence of adult respiratory distress syndrome, and effects of methylprednisolone administration.
abstract: We assayed serial plasma samples from 86 patients, who were enrolled in a prospective randomized trial of the effects of methylprednisolone (MPSS) in septic shock, for the presence of cytokine tumor necrosis factor (TNF) using an enzyme-linked immunosorbent assay. TNF was present in the plasma of 27 of the 74 patients with septic shock, but in only 1 of the 12 patients with shock due to other causes. TNF was detected with equal frequency in patients with shock from gram-negative or from gram-positive bacillary sepsis. TNF levels were highest on the initial sample and decreased significantly over the subsequent 24 h in both the patients treated with MPSS and in those given placebo. Patients with detectable TNF had a higher incidence and severity of the adult respiratory distress syndrome and a higher mortality rate than did patients without detectable TNF.
authors.affiliation: Department of Anesthesia, University of California, San Francisco.
authors.forename: J D
authors.initials: JD
authors.lastname: Marks
authors.forename: C B
authors.initials: CB
authors.lastname: Marks
authors.forename: J M
authors.initials: JM
authors.lastname: Luce
authors.forename: A B
authors.initials: AB
authors.lastname: Montgomery
authors.forename: J
authors.initials: J
authors.lastname: Turner
authors.forename: C A
authors.initials: CA
authors.lastname: Metz
authors.forename: J F
authors.initials: JF
authors.lastname: Murray
mesh_terms: D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use*; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D012769:Shock / Q000097:blood; D012772:Shock, Septic / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000401:mortality; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D008775:Methylprednisolone